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EPR - Why would you not use it if available?
#21
(05-12-2016, 01:15 PM)robertbuckley Wrote: There is science involved with C/A/Bi-Pap and there is also art. repeat after me Ladies and Gentlemen, Boys and Girls, and children of all ages - We are all different,

And also, we are all changing. What works for us at fifty might not work so good at 70.


Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
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#22
I like epr 3 and yet some people shut epr right off.
Its your preference and 3 epr makes me breath more normal with excellent results.
Its sort of like a bi-pap almost, with good results, why make breathing difficult.
If you have to wear a mask to sleep its your duty to tweak the machine to its best performanceMornincoffee.
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#23
(05-12-2016, 06:12 PM)eseedhouse Wrote:
(05-12-2016, 01:15 PM)robertbuckley Wrote: There is science involved with C/A/Bi-Pap and there is also art. repeat after me Ladies and Gentlemen, Boys and Girls, and children of all ages - We are all different,

And also, we are all changing. What works for us at fifty might not work so good at 70.

eseedhouse - are you inferring that I have hit my 7th decade? Cool Don't know whether to be complimented or insulted, but, yes, we are all always changing. (3 shy, but who is counting?)
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#24
(05-13-2016, 11:56 AM)robertbuckley Wrote: [quote='eseedhouse' pid='161662' dateline='1463094729']
eseedhouse - are you inferring that I have hit my 7th decade? Cool Don't know whether to be complimented or insulted, but, yes, we are all always changing. (3 shy, but who is counting?)

Well, I can only suggest that you might want to look up the meaning of "infer". I wasn't "inferring" anything. I now infer from your use of the word in that particular context that you really wanted to ask me if I was implying anything.

I wasn't implying anything. You might have inferred that I was implying something but that's you.

Someone who is 70+ is actually in their eight decade of life, by the way.

I am among them.

Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
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#25
(05-13-2016, 12:08 PM)eseedhouse Wrote: I wasn't implying anything.

Then let's just leave it at that.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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#26
(05-11-2016, 08:40 PM)green wings Wrote: Just want to confirm I understand what you mean, Alan. Are you saying that when you use EPR, you end up with different behavior from the machine's pressure response algorithm than when EPR is turned off?

My machine doesn't behave any different than any other Airsense 10. My AHI rises slightly (more Ha and Oa) when I have EPR on. With EPR on my funky breathing pattern returns. It also shows an increase in snore and flow limits. I seem to rest easier with a steady pressure. Barring any events of course. My AHI is still well below 5. With a typical night <1.

Example of normal vs funky pattern
Normal:
[Image: sh-flowrate1.PNG]

not:
[Image: sh-flowrate2.PNG]

The "not" can go on for more than an hour. I'm not blaming this on EPR. I had the same pattern at lower pressure with EPR off and it went away when I raised my min.


Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie

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#27
As for the question "Why would you not use it if available?"

I don't use EPR for 2 reasons:
1- Tried it and I didn't like it
2- I use an AutoSet, adjust pressure as needed throughout the night between lower and higher pressure
I don't think would derive any any benefit from using it ... YMMV
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#28
(05-13-2016, 06:26 PM)AlanE Wrote: Example of normal vs funky pattern
Normal:
[Image: sh-flowrate1.PNG]

not:
[Image: sh-flowrate2.PNG]

Hi AlanE,

The first graph looks like a Flow waveform. "Flow" is the estimated rate of air entering (positive Flow) and exiting (negative Flow) our lungs. The Flow has units of volume per unit time (for example mL per sec).

The second graph looks like what ResMed names the High Rate Pressure (SleepyHead names this the "Mask Pressure") waveform, which is the estimated pressure in our mask.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#29
I find that I need to change EPR settings occasionally. So, don't be afraid to play with the settings to find your new comfort level. I seem to have issues with seasonal change (furnace, air conditioning, hot, cold, windows open all seem to need different settings).
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#30
I think everyone else has established that everyone is different. Speaking for myself... when I first started I played around with EPR a bit. I found a setting of 3 to be very distracting/uncomfortable. I kind of felt like Wile E. Coyote when he runs off a cliff but gravity doesn't kick in until he looks down and then... SPLAT!

That said... I think the algorithm with regards to HOW the pressure is released makes a HUGE difference in how I tolerate it. I'm no longer using CPAP and was changed to an ASV machine. The equivalent minimum EPR of my Aircurve 10 ASV would be 6 with my current settings (EPAP of 4 with minimum pressure support of 6)... my machine always drops me down to 4 cm on exhale which means that sometimes, the equivalent EPR would be 15 (max PS of 15 for an IPAP of 19). At my last sleep study I IMMEDIATELY noticed when they switched me over to ASV but it must have been a different algorithm as I had that floor-vanishing-out-from-underneath-me feeling. It woke me up immediately and I couldn't get back to sleep. It felt like more of a square wave. The way my Aircurve drops the pressure feels more gradual... more sinusoidal in nature.

I'm guessing there's probably differences between manufacturers in how their equivalent EPR feature is implemented which probably adds to some of the reasons why some people say they tolerate certain brands better than others, or get better results with a particular brand over another.
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